HYPERTENSION IN PRIMARY HYPERPARATHYROIDISM: A CASE REPORT OF ECTOPIC PARATHYROID ADENOMA
Journal
Македонски Медицински Преглед = Macedonian Medical Review
Date Issued
2024
Author(s)
Vejseli, Ron
Arbutina, Suzana
Trajkovska, Tina
Kuzmanoska, Ivana
Bojadzioska, Maja
Asani, Elldar
Taseva, Latinka
Abstract
Primary hyperparathyroidism is a condition characteri-
zed by excessive production of parathyroid hormone,
often caused by an adenoma or hyperplasia of the
parathyroid gland. One of the rare presentations of
primary hyperparathyroidism is the development of an
ectopic parathyroid adenoma, which can be challen-
ging to diagnose and localize. Hypertension is observed
seen in many cases of primary hyperparathyroidism
(PHPT), although the exact mechanism is yet unclear.
This paper aims to provide a comprehensive review of
the current understanding of primary hyperparathy-
roidism, with a focus on the presentation of ectopic
adenomas and the relationship between primary hyper-
parathyroidism and resistant hypertension. While most
parathyroid adenomas are located in the normal ana-
tomical position of the parathyroid glands, a small
percentage (approximately 2-5%) can occur in ectopic
locations, such as the thyroid gland, carotid sheath, or
mediastinum. The atypical location of ectopic parathy-
roid adenomas can make them more difficult to iden-
tify and remove surgically, which can be difficult diag-
nostic challenge. The prevalence of primary hyperpa-
rathyroidism has been estimated to be around 0.1-0.4%
in the general population, with a higher incidence in
postmenopausal women.
The imaging tests consist mainly of an initial 99mTc-
sestamibi SPECT/CT. Sensitivity and specificity of
sestamibi scans are between 73%-80%, respectively.
Clinical sensitivity is increased to 96% when sestamibi
scans are combined with ultrasound
zed by excessive production of parathyroid hormone,
often caused by an adenoma or hyperplasia of the
parathyroid gland. One of the rare presentations of
primary hyperparathyroidism is the development of an
ectopic parathyroid adenoma, which can be challen-
ging to diagnose and localize. Hypertension is observed
seen in many cases of primary hyperparathyroidism
(PHPT), although the exact mechanism is yet unclear.
This paper aims to provide a comprehensive review of
the current understanding of primary hyperparathy-
roidism, with a focus on the presentation of ectopic
adenomas and the relationship between primary hyper-
parathyroidism and resistant hypertension. While most
parathyroid adenomas are located in the normal ana-
tomical position of the parathyroid glands, a small
percentage (approximately 2-5%) can occur in ectopic
locations, such as the thyroid gland, carotid sheath, or
mediastinum. The atypical location of ectopic parathy-
roid adenomas can make them more difficult to iden-
tify and remove surgically, which can be difficult diag-
nostic challenge. The prevalence of primary hyperpa-
rathyroidism has been estimated to be around 0.1-0.4%
in the general population, with a higher incidence in
postmenopausal women.
The imaging tests consist mainly of an initial 99mTc-
sestamibi SPECT/CT. Sensitivity and specificity of
sestamibi scans are between 73%-80%, respectively.
Clinical sensitivity is increased to 96% when sestamibi
scans are combined with ultrasound
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